Organization Active NPI

Wells of Wellness, LLC

  • Mental Health Counselor
  • Roslindale, MA
National Provider Identifier
1174120513
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELLS OF WELLNESS, LLC
Doing business as
Wells of Wellness Center
Practice address
993 South Street
Apt, Suite, Floor, Etc.
Roslindale, MA 02131
Phone
(857) 204-6773
NPI assigned
Oct 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Jeannetta V Montissol, LMHCNPI 1154990208
Title
Ceo
Phone
(857) 204-6773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Home Health Agency 251E00000X
Clinic/Center 261Q00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X

Addresses

Primary practice location

993 South Street
Apt, Suite, Floor, Etc.
Roslindale, MA 02131

Mailing address

40 Charme Ave
Roslindale, MA 02131-3113
Phone (857) 204-6773

Other names 1

  • Wells of Wellness Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1174120513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CHARME AVE",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313113",
            "telephone_number": "857-204-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 SOUTH STREET",
            "address_2": "APT, SUITE, FLOOR, ETC.",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "02131",
            "telephone_number": "857-204-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS OF WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "MONTISSOL",
        "authorized_official_first_name": "JEANNETTA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "857-204-6773",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wells of Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.